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uchangeng
19-03-2005, 06:46 PM
How often do you make a claim to your medical insurance?

The last time I visited my doctor, he asked me whether I had a medical insurance to cover the cost. My answer was " Yes, I have one, no problem.". I regretted saying that.

One week after the treatment, I was slapped with a bill that came close to a 5 digit number for a surgery and treatment I was supposedly needing at the hospital. Being a patient, I admit that I have no say in how the doctor was going to do his job, but at least, I expect the doctor to advise the most economical, most cost effective way of treating my condition. And, I need to know how much I was going to pay.

After settling the bill with my insurance, my premium went up, vertically! Money don't fall off the sky, I am paying a much higher premium and there is no way to tell how much I am going to pay back.

My advice is, when u go see a doctor, never tell the doctor u have a policy to cover the cost and that, you need to know the cost before anything is done. Seek a second opinion on major treatment if you need to. May be you don't need to be operated on. And if the doctor advise a "minor" surgery, make sure it is a surgery and it is worth the money. The guy may just open a slit somewhere and do a clean up job and stitch u back.

It is a case of insurance premium versus medical cost. The doctor knows he can easily make a claim against the insurance company for whatever treatment cost he renders, and the later is always happy to pay the claim. Reason? the insurance company has perfect reason to raise the premium later and the "victim" would be made to pay escalating premium the rest of his natural life. At the end of the day, both the doctor and the insurance company make all the money they want, the patient suffer! Worse, if you do not have a policy, you may not have access to the medical treatment at all! In another word, limited access to hospital!

bugbear
19-03-2005, 07:43 PM
Beware, this is the face of medicine of the future. Medicine have become a very big business especially the private sector.

jadewhite
20-03-2005, 01:30 AM
uchangeng, I could agree with you. I have the same encounter as you. This doctor was highly recommended by my friend for being very very professional and ethical person. On my first visit, I was make known that I must go for the operation immediately as it was rather serious. And of course the doc did asked me whether I have a medical insurance.

After the op, I was still bleeding. Hence, the doctor requires me to go for dressing everyday. Each time, I went there for the dressing, it cost me about RM100.00 As the bleeding did not stop for more than a week, I consulted another doctor in Universiti Hospital.

I was in for a rude shock. I got to know that the doctor whom operates me did not do a good job. That was the reason why I am still bleeding. The doctor in UH was rather emphatic. He carried out a minor surgery immediately. Viola ..... I started to bleed lesser and finally it stops within 2 days.

During the consultation with the UH doctor, I learned another painful lesson. I need not to be operated. Medication can easily solved my problem. Secondly, the private doctor did not do a good job.

My mum used to have headache. After going thru months of medication and scanning from a private hospital, the doc told my mum she needs to go for a brain surgery. The chances of recovery would be 50% and the bills will amount to RM250k

As I already had a bad encounter, we suggested my mum to go to UH for a second opinion. Guess what???? She don't need the ops. She needs to go for phisioteraphy to solve her problem. And within 1/2 year, her headache gone.

In short, Don't ever trust what the docs says. Always seek for a second opinion.

uchangeng
21-03-2005, 03:27 PM
Another advice, when u go see a private doc., don't ever tell him what a top and fat-salary-job u have got. because if you do, you can guarantee to see a big bill with big numbers coming your way!

my lawyer fren went to see a doctor, had an op. and he related to me this experience. the doc asked him his job. being a snr. partner of the firm, he told the doc. what his job was. great. a snr partner of a law firm in KL., major customer included big foreign bank. must be well paid, fat salary and all the perks you can have. when he recievd his bill, it was big, real big. my fren refused to pay and wrote to the hospital his reason for not wanting to pay the bill in full. being a lawyer, the hospital admin. knew what they could end up with if the matter was not settled quick and swift. some months later, my fren received an amended bill, this time, the number appreared reasonable, the number reduced and, wah..lah..., he paid up and saved himself the financial destruction! how he did that was anybody's guess.

PeterLee
21-03-2005, 03:56 PM
When we buy a TV, if it is not working, we can return back or come to the worse, get refund from small claims court.
When we go to hospital, if it is wrong diagnosis, or over prescription or substandard operation, where can we turn to?
It is very difficult to sue a doctor, you need a medical professional who is willing to back you up in court in order to sue another medical professional.
We are at their mercy.

Joe Gomez
21-03-2005, 04:33 PM
Under such circumstances, arent the Ministry of Health and the Malaysian Medical Association the correct bodies to complain to ?

Felix The Cat
21-03-2005, 04:47 PM
This is so horrible..
Now i don't believe medical insurance anymore..

sarahjersey
21-03-2005, 04:52 PM
Medical insurance for STD ??


Malaysian hobby is porn ??

www.kumpulanfiles.cjb.net

http://groups.yahoo.com/group/malay_chics

Huaduh

Joe Gomez
21-03-2005, 04:54 PM
Can someone enlighten me pls ?
Are we talking of "Hospitalisation Insurance" here ?

Can I claim against this insurance if I was not hospitalised ? For instance, I cant claim for a bill from a specialist ( unless I was hospitalised ) right ?

CCY
21-03-2005, 04:58 PM
Mods.... This s..o..b.. Sarahjersey is here to stir big trouble...

orchipalar
21-03-2005, 05:05 PM
Search: Posts Made By: sarahjersey
Forum: Announcement Today, 04:55 PM
Replies: 1
Language Classes
Views: 61
Posted By sarahjersey
Re: Language Classes

What is in English "Malaysia mencuri Ambalat"

www.kumpulanfiles.cjb.net

Forum: USJ Subang Jaya Web Forum Today, 04:52 PM
Replies: 9
medical inurance.
Views: 206
Posted By sarahjersey
Re: medical inurance.

Medical insurance for STD ??

Malaysian hobby is porn ??

www.kumpulanfiles.cjb.net

http://groups.yahoo.com/group/malay_chics

Huaduh

Forum: Legally Speaking Today, 04:48 PM
Replies: 2
Malaysian lawyers to study case
Views: 144
Posted By sarahjersey
Re: Malaysian lawyers to study case

Apa hukumnya mencaplok Ambalat ?

www.kumpulanfiles.cjb.net

Forum: Photography Today, 04:46 PM
Replies: 1
Photobugs - Learn lighting skills from Chan Bing Fai (FRPS)
Views: 97
Posted By sarahjersey
Re: Photobugs - Learn lighting skills from Chan Bing Fai (FRPS)

www.kumpulanfiles.cjb.net

Wow.. malaysian hobby photo porn yah...!

Save Ambalat..!

Forum: Internet & Trendlines Today, 04:44 PM
Replies: 16
Thank You Tmnet
Views: 388
Posted By sarahjersey
Re: Thank You Tmnet

Yes.. but how about the syar'i.

mencaplok wilayah negara lain hukumnya ape ??
Showing results 1 to 5 of 5

Err...CCY:) is right...intruder alert!!!...this guy is going on a rampage! :rolleyes:

mlin
21-03-2005, 05:05 PM
joe,

from what i understand, if ur outpatient consult eventually leads u to hospitalization, and if the insurance covers for it, u may claim for ur outpatient bill as well.

uchangeng
21-03-2005, 09:10 PM
hospitalisation insurance normally only pay when you are hospitalised. otherwise, you pay the bill yourself. so, if you think you get hospitalised just so that you can claim, you are all wrong! remember, no matter what happen, the money you claim will still comes from your pocket, eventually, your premium will increase after the claim!

do you think the insurance firm will let you claim more than what you pay in premium? if they do, they eat what?

clarence
21-03-2005, 09:22 PM
Its all depends on the type of insurance you buy from. In my company, premium does not increase due to excessive claim, Premium increases due to increase of age and NOT due to claim experience.
So always be careful where you buy from.

SharL
21-03-2005, 10:50 PM
If you have the health insurance, find out what is your coverage before you go for the treatment/consultation/surgery/admission. Cover for local hospital and/or foreign? Check up the max $$ you are covered, whether you will be reimbursed in full or only x% of what you pay. It will be good if you "shop" around to ask for which hospital/doctor has "reasonable charges". Some health insurance only allow you to go to the "panel" hospitals. Watch for exclusion clause - like how long you have to buy it in order to be eligible for the benefits, etc. Ask the insurance company what are the documents required in order to file a claim. Original Receipt and medical report are usually the must. And try to ask for "discount" from the doctor. :)

davidfkc
22-03-2005, 12:54 AM
I believe Clarence is speaking for the industry too. I did a fair bit of research on medical insurance prior to getting my family insured. I have not come across any insurer who loads the premium for an existing condition. They all chicken out and provide coverage for the same premium but with an additional clause - the dreaded and unjust exclusion clause.

jessi24
22-03-2005, 03:15 AM
Whenever anyone wants to purchase any insurance coverage for hospitalization:
1) check on annual coverage
2) life time limit
3) how much is covered for surgical.
4) how much is covered for room and board.
5) medication, etc.....
6) some companies only covers 90% some 100%. Some if exceeds the room and board, you cannot top up - need to cover 20% or 10% of total bill.
Currently have only found 2 hospitalisation insurance companies which guarantees renewal (stated in policy) when purchaser suffers from 1 off the 36 critical illness until lifetime limit is used up. The rest of the companies have a right to terminate the purchaser the following year. One is MAA the other is a scottish company(can't remember name). :o
Read up all the small prints in your policy.(use a magnifying glass if you have to). If unsure call up to ask.

orchipalar
22-03-2005, 08:58 AM
Err...this is happening with our own family medical insurance package...n there are areas where Orchi isn't happy with it...but were told that every other insurance company does the same freaking thingy...err...for those active in marketing these medical or so called hospitalization insurance plans...care to shed some light?...your explanation is much appreciated... :)

1. Parents aged 45 yo n 37 yo respectively, no claims ever since the last 10 years...

2. Eldest children 9 yo, had so far chalked up only 1 claim...hospitalized for high fever earlier suspected of dengue fever in a private hospital.(5 years ago) total claim: rm 1300 or so.

3. Youngest children 6 yo, had so far chalked up only 1 claim...hospitalized for food/viral poisoning in digestive system.(3 years ago)...total claim: rm1600 or so

But every year since...insurance company exercise 'loading' to beef up yearly premiums...??? :confused:

Yearly current premium about rm2000++!!! :eek: :confused:

IF there is a kind person out there who is willing to share their better n more pleasant experience buying these insurance...please HELP!!!...by providing the contacts to the insurance agent to that generous insurance company....TQTQTQ :)

totoro
22-03-2005, 09:08 AM
Err...this is happening with our own family medical insurance package...n there are areas where Orchi isn't happy with it...but were told that every other insurance company does the same freaking thingy...err...for those active in marketing these medical or so called hospitalization insurance plans...care to shed some light?...your explanation is much appreciated... :)

1. Parents aged 45 yo n 37 yo respectively, no claims ever since the last 10 years...

2. Eldest children 9 yo, had so far chalked up only 1 claim...hospitalized for high fever earlier suspected of dengue fever in a private hospital.(5 years ago) total claim: rm 1300 or so.

3. Youngest children 6 yo, had so far chalked up only 1 claim...hospitalized for food/viral poisoning in digestive system.(3 years ago)...total claim: rm1600 or so

But every year since...insurance company exercise 'loading' to beef up yearly premiums...??? :confused:

Yearly current premium about rm2000++!!! :eek: :confused:

IF there is a kind person out there who is willing to share their better n more pleasant experience buying these insurance...please HELP!!!...by providing the contacts to the insurance agent to that generous insurance company....TQTQTQ :)


I went to the hospital twice in the past month. The charges were ridiculous (and I agree with the other thread that says quite a number of private doctors are out to skin you alive). As I was under company insurance, I had partial coverage. However, it is because if the policy plan that the company itself had to fork out the larger amount, rather than the insurance company.

However, we came to learn that if I had chosen to be hospitalized and become an in-patient case instead, then I will be entitled to claim 100% from the insurance company.

As I was unsure of the policy details as it was newly introduced, I decided to stay opt for out-patient treatment, and I guess though it saved everybody some money, it was me and my company who had to fork out most of the $.

totoro
22-03-2005, 09:13 AM
Err...this is happening with our own family medical insurance package...n there are areas where Orchi isn't happy with it...but were told that every other insurance company does the same freaking thingy...err...for those active in marketing these medical or so called hospitalization insurance plans...care to shed some light?...your explanation is much appreciated... :)

1. Parents aged 45 yo n 37 yo respectively, no claims ever since the last 10 years...

2. Eldest children 9 yo, had so far chalked up only 1 claim...hospitalized for high fever earlier suspected of dengue fever in a private hospital.(5 years ago) total claim: rm 1300 or so.

3. Youngest children 6 yo, had so far chalked up only 1 claim...hospitalized for food/viral poisoning in digestive system.(3 years ago)...total claim: rm1600 or so

But every year since...insurance company exercise 'loading' to beef up yearly premiums...??? :confused:

Yearly current premium about rm2000++!!! :eek: :confused:

IF there is a kind person out there who is willing to share their better n more pleasant experience buying these insurance...please HELP!!!...by providing the contacts to the insurance agent to that generous insurance company....TQTQTQ :)

Orchi... what did your kindly insurance agent/company tell you when they increased the loading on your premium? What was the reason given? Can you PM me the company which did this?

PeterLee
22-03-2005, 09:14 AM
Orchi, not every expensive thing is good.
My family Hospitalisation & Surgical insurance costs below RM500.00.
It is through AAM - a group policy initially undertaken by SEA and then later by AHA. Even my company insurance staff said it is cheap.
so far for the past 10 years I have claimed over RM30,000 for various hospitalisaton bills done by my children and wife, there is no loading. Payment is fast, about 1 to 2 wks.

totoro
22-03-2005, 09:16 AM
Orchi, not every expensive thing is good.
My family Hospitalisation & Surgical insurance costs below RM500.00.
It is through AAM - a group policy initially undertaken by SEA and then later by AHA. Even my company insurance staff said it is cheap.
so far for the past 10 years I have claimed over RM30,000 for various hospitalisaton bills done by my children and wife, there is no loading. Payment is fast, about 1 to 2 wks.

AHA? American Home Assurance, the general insurance company?

PeterLee
22-03-2005, 09:24 AM
Yes, Totoro, it is American Home Assurance.

totoro
22-03-2005, 09:25 AM
Yes, Totoro, it is American Home Assurance.

Oic, I thought AHA did general insurance, e.g. car, house, business, while AIA did life insurance, e.g. medical, hospital, life, etc... :D

Joe Gomez
22-03-2005, 10:00 AM
Whenever anyone wants to purchase any insurance coverage for hospitalization:
1) check on annual coverage
2) life time limit
3) how much is covered for surgical.
4) how much is covered for room and board.
5) medication, etc.....
6) some companies only covers 90% some 100%. Some if exceeds the room and board, you cannot top up - need to cover 20% or 10% of total bill.Good piece of advise, jessi24. I think u know that a lot of people who buy policies do not know what they are buying. There should have been no surprises at all insofar as insurance is concerned. Every material thing that the polcy will pay for is in the darn document. Yet there are surprises and what is worse the surprises happen at the time when the affected party needs all the assistance he/she can get ..... i.e. when a loved one is hospitalised & money is of utmost importance. The surprise is usually because of a lack of awareness of what the policy offers. Why this ignorance ?
Reason # 1
The darn policy documents are so voluminous and filled with legalese, bordering on gibberish .... it is a frightening experience just reading the darn thingey. Why ? To state the obvious, this is a contract. It is enforceable in the courts. It is entered into on a willing-offeror-willing-acceptor ( there is no such legal term lah but u know what I mean ) basis.
Reason # 2
We place too much faith on the agent's ability to understand our requirements, ......... often the agent is a trusted friend or relative and worse still the bloke may not be in insurance anymore eg. I have policies from 5 different agents from 3 different companies .... not one of the agents is in the insurance business anymore. Therein is one of the reasons for my going into this business. I know now what I have signed for and am able to advise with some measure of confidence and empathy.


Currently have only found 2 hospitalisation insurance companies which guarantees renewal (stated in policy) when purchaser suffers from 1 off the 36 critical illness until lifetime limit is used up. The rest of the companies have a right to terminate the purchaser the following year. One is MAA the other is a scottish company(can't remember name). :o
Read up all the small prints in your policy.(use a magnifying glass if you have to). If unsure call up to ask.Actually, jessi24, a good number of the big players offer this. Great Eastern ( wher I am from ) does. So does Prudential, if I am not mistaken. This is usaually offered as part of the Investment Linked plans (ILP). Speaking for GELA alone ( I am not too sure of details of others ) ....If the Investment Linked Hospitalisation Plan ( ILHP ) is part of ILP, there shd be no subsequent loading of premiums, no subsequent introduction of exclusion clauses. Loading & exclusion clause can only happen at point of entry. The hospitalisation cover shd run till age 70 years OR upon death OR upon exhaustin lifetime limit. nothing else shd touch the benefit.
However, if the plan taken is on an annual basis, ( ie.e the one where we apply for every year and the premium rises according to age ) the insurance company will and does load premiums & does introduce exclusion clauses. This raises the question " Why did the agent not inform the client accordingly ?" Therein lies the reason for the sorry state of the image of us insurance blokes !!! :( :( :(
Insurance companies are in th business of convering risks. To get some idea of what risks are entailed in this business, the insurers hire chappies called "actuaries" to analyse & number crunch demographic stats.
The whole viability of the insurance business rests on the concept of pooling of the resources of the many to cover for the misfortune of the few. There are some risks, of course, that are no risks at all .... they are virtual certainties .... DEATH for instance.

orchipalar
22-03-2005, 10:04 AM
Orchi, not every expensive thing is good.
My family Hospitalisation & Surgical insurance costs below RM500.00.
It is through AAM - a group policy initially undertaken by SEA and then later by AHA. Even my company insurance staff said it is cheap.
so far for the past 10 years I have claimed over RM30,000 for various hospitalisaton bills done by my children and wife, there is no loading. Payment is fast, about 1 to 2 wks.

Err...TQ PeterLee:) for that piece of advise...but for that amount...does it cover your own coverage or for the whole family?

totoro
22-03-2005, 10:31 AM
Another advice, when u go see a private doc., don't ever tell him what a top and fat-salary-job u have got. because if you do, you can guarantee to see a big bill with big numbers coming your way!


This happens a lot everywhere! I often find that when I eat food dressed as a student, I get good prices, but when I go there during working hours when I am dressed up, I get charged more!

Some Indian restaurants I've been to charge RM7-RM8 for a normal plate of mixed rice with just 3 vegetables and a teh ais limau!

HTH
22-03-2005, 10:34 AM
My mum used to have headache. After going thru months of medication and scanning from a private hospital, the doc told my mum she needs to go for a brain surgery. The chances of recovery would be 50% and the bills will amount to RM250k

As I already had a bad encounter, we suggested my mum to go to UH for a second opinion. Guess what???? She don't need the ops. She needs to go for phisioteraphy to solve her problem. And within 1/2 year, her headache gone.


Wah! This is too much!

My medical insurance is covered by my company, for outpatient and for specialist consultation (if you have a supporting letter from the GP). I spoke to my GP and he said it's really difficult to claim back from the insurance company, it took him more than 6 months to claim back. Also there's a limit that the doc can claim from the insurance company. I thnk about RM30.

So according to him, sometime certain GPs are very reluctant to see patients with medical insurance, because trouble of getting back the claims and also the claim limit.

Everything's about money, money, money!

Joe Gomez
22-03-2005, 10:48 AM
The fact that the insurance company pays .... is a big help. There is no denying this. Experiences will be varied from "very speedy" to "downright inefficient " service provided.
Whether the insurance company loads premiums and / or includes exclusion clauses wld depend very much on the plan.

As for medical attention, uchangeng, pls get a second opinion before committing to having such things done at hospitals. Get estimates ( typically it is difficult for the doc's to be accurate ) of cost in both cases. Compare b4 committing.
The fact that the doctor is seeking to milk the insurance company thru the patient is despicable.

orchipalar
22-03-2005, 10:58 AM
The fact that the doctor is seeking to milk the insurance company thru the patient is despicable.

Err...JG:)...usually he/she does it thru the despicable hospitals as well... :o

keith
22-03-2005, 11:15 AM
Good piece of advise, jessi24. I think u know that a lot of people who buy policies do not know what they are buying. There should have been no surprises at all insofar as insurance is concerned. Every material thing that the polcy will pay for is in the darn document. Yet there are surprises and what is worse the surprises happen at the time when the affected party needs all the assistance he/she can get ..... i.e. when a loved one is hospitalised & money is of utmost importance. The surprise is usually because of a lack of awareness of what the policy offers. Why this ignorance ?
Reason # 1
The darn policy documents are so voluminous and filled with legalese, bordering on gibberish .... it is a frightening experience just reading the darn thingey. Why ? To state the obvious, this is a contract. It is enforceable in the courts. It is entered into on a willing-offeror-willing-acceptor ( there is no such legal term lah but u know what I mean ) basis.
Reason # 2
We place too much faith on the agent's ability to understand our requirements, ......... often the agent is a trusted friend or relative and worse still the bloke may not be in insurance anymore eg. I have policies from 5 different agents from 3 different companies .... not one of the agents is in the insurance business anymore. Therein is one of the reasons for my going into this business. I know now what I have signed for and am able to advise with some measure of confidence and empathy.

Actually, jessi24, a good number of the big players offer this. Great Eastern ( wher I am from ) does. So does Prudential, if I am not mistaken. This is usaually offered as part of the Investment Linked plans (ILP). Speaking for GELA alone ( I am not too sure of details of others ) ....If the Investment Linked Hospitalisation Plan ( ILHP ) is part of ILP, there shd be no subsequent loading of premiums, no subsequent introduction of exclusion clauses. Loading & exclusion clause can only happen at point of entry. The hospitalisation cover shd run till age 70 years OR upon death OR upon exhaustin lifetime limit. nothing else shd touch the benefit.
However, if the plan taken is on an annual basis, ( ie.e the one where we apply for every year and the premium rises according to age ) the insurance company will and does load premiums & does introduce exclusion clauses. This raises the question " Why did the agent not inform the client accordingly ?" Therein lies the reason for the sorry state of the image of us insurance blokes !!! :( :( :(
Insurance companies are in th business of convering risks. To get some idea of what risks are entailed in this business, the insurers hire chappies called "actuaries" to analyse & number crunch demographic stats.
The whole viability of the insurance business rests on the concept of pooling of the resources of the many to cover for the misfortune of the few. There are some risks, of course, that are no risks at all .... they are virtual certainties .... DEATH for instance.

As far as I know, if the medical plan / medical card that is tied to a life plan, then the premium is fixed at entry, and should remain throughout.

On the other hand, if it's a general insurance products, then it's renewalable every year, and the insurer has the right to increase premium by loading during renewal time.

totoro
22-03-2005, 11:17 AM
As far as I know, if the medical plan / medical card that is tied to a life plan, then the premium is fixed at entry, and should remain throughout.

On the other hand, if it's a general insurance products, then it's renewalable every year, and the insurer has the right to increase premium by loading.

This is not true. The premium for the medical rider still increases every year, and is charged separately.

For the new ILP, the premiums are also increased every year, but is deducted accordingly from your cash value in your plan.

keith
22-03-2005, 11:21 AM
This is not true. The premium for the medical rider still increases every year, and is charged separately.

For the new ILP, the premiums are also increased every year, but is deducted accordingly from your cash value in your plan.

If that's the case, loading can happen whether it's life or general product medical plan?

Some agent from life side told me their product (fixed premium and guaranteed renewable) is better than the national medical card plan (which is a general product),... so it's not true at all.

Then we are at the mercy of insurance companies.... :(

Joe Gomez
22-03-2005, 11:23 AM
The fact that the doctor is seeking to milk the insurance company thru the patient is despicable.

Err...JG:)...usually he/she does it thru the despicable hospitals as well... :o
Yes and the patient is the innocent party in all this.
Hospitals I am told work hand in hand with their staff of doctors and allow such practices to continue.
Insurance frauds in other countries have hit the newspapers in the past. Insurance companies are milked as well. Please dont get me wrong. I dont wish to paint the average insurance company as the good samaritan .... the guys who brush offf the tear from the eye of the family in need. This is all BULL**** and mere hype. The well known fact is that Insurance companies are in the business not out of the goodness of their hearts lah. They are in it becoz there is money to be made while performing a very useful task.
The side effects are that doctors and people like that try to take the insurers for a ride. Motor insurance is a classic case where this is rampant.Here the average joe and the mechanic and the adjuster do some rather fancy stuff with claims.
So insurance companies are always on the guard to make sure they are not taken to the cleaners .... that they remiain in business ............ so they can continue to meet the obligations for all the other honest claims.

orchipalar
22-03-2005, 11:42 AM
Err...so now this is what Orchi wishes for...appreciates any good suggestions by PM only wor...:)

1. Husband 45yo(smoker)...absolutely no history of hospitalization whatsoever.
2. Wifey 37yo(asthmatic) no history of hospitalization otherthan when giving birth to...
3. Son 9yo...hospitalized once for high fever.
4. Son 6yo...hospitalised once for suspected food poisoning.

Orchi shall pay the best yearly premiums...for the best possible medical benefits worldwide from any reputable insurer...no future loadings...no BS!...guaranteed renewals for the same!

How much?...n where to sign up?

Joe Gomez
22-03-2005, 12:05 PM
totoro is right.
An Investment Linked Plan (ILP) is by its very nature associated with one or more investment funds in the background. This means if the investments do well and the value of the funds/units is sufficient to cover any increase in premium charges ...... well and good, the increases will be transparent to us.

Unseen to us the premium associated with the hospitalisation plan would increase with age. The total premium paid may not change depending on the performance of the funds as mentioned above.

What happens if the funds dont perform well ?
The insurer could adjust the cover provided accordingly.

btw, all of us are probably aware that all non-ILP type of policies (collectively referred to as traditional policies ) will be discontinued soon. Initially, the papers of 12th & 13 March said that BNM has announced the discontinuance of such policies and this will take effect from 1st April onwards. I am told now that a couple of the products have been extended till 30th April and insurance companies are appealing to BNM to hold others till June. Not sure what the outcome will be.
In the light of the impending discontinuance, I think, all of us shd get as familiar with the ILPs as possible. It can be rather confusing initially.

totoro
22-03-2005, 12:24 PM
btw, all of us are probably aware that all non-ILP type of policies (collectively referred to as traditional policies ) will be discontinued soon. Initially, the papers of 12th & 13 March said that BNM has announced the discontinuance of such policies and this will take effect from 1st April onwards. I am told now that a couple of the products have been extended till 30th April and insurance companies are appealing to BNM to hold others till June. Not sure what the outcome will be.
In the light of the impending discontinuance, I think, all of us shd get as familiar with the ILPs as possible. It can be rather confusing initially.

I am unaware of this! I don't think this is correct, JG? BNM actually wanted to allow partial refunds for traditional life policies if surrendered within 1 year. This results in higher premiums for such policies of 5-10%, but not discontinuance...

Joe Gomez
22-03-2005, 01:24 PM
I am unaware of this! I don't think this is correct, JG? BNM actually wanted to allow partial refunds for traditional life policies if surrendered within 1 year. This results in higher premiums for such policies of 5-10%, but not discontinuance...
Had rushed off for lunch ..... just got back.
Yes .... my mistake.
I shd have said that as a result of a decision by BNM ( i.e. regarding allowing such surrender ), several insurance companies are considering discontinuing traditional policies.

Insurance companies are tying the 2 together i.e. if BNM goes ahead several insurance companies will drop traditional policies. Apparently the product become no more viable. But it is also likely that this is an arm twisting manoeuvre

thks totoro.

Pls refer to article in Star 12th March here (http://thestar.com.my/news/story.asp?file=/2005/3/12/nation/10402053&sec=nation).

totoro
22-03-2005, 01:32 PM
If that's the case, loading can happen whether it's life or general product medical plan?

Some agent from life side told me their product (fixed premium and guaranteed renewable) is better than the national medical card plan (which is a general product),... so it's not true at all.

Then we are at the mercy of insurance companies.... :(

it's not actually loading, but the pre-calculated premium for an age or age group.

You can easily find out how much premium you will need to pay from this year until the year the medical plan expires, e.g. from age 45 to age 70, and you can easily see how the medical premiums increase with age (which makes sense, right?), i.e. you know how much more premium you need to pay at age 65 even today.

Your life insurance agent must be refering to the ILP. The premium you pay is fixed, nonetheless the 'cost of insurance' deducted from your investment-linked policy will still increase every year according to your age.

As JG said, this increase in the 'cost of insurance' for your medical riders should be offset by your investment gains (if any), but there is always the possibility that your investment-linked funds did not gain enough to offset the increase in premiums, or worse yet, your investment-linked funds ended up losing money.

That is when you will get a nice letter from the insurance company advising you to top-up your investment-linked policy account, as your investment-linked fund has run out and there is no money left to pay off your 'cost of insurance'.

Always bear in mind that for ILP, the policyholders bear all the risk for their investments.

keith
22-03-2005, 01:36 PM
Insurance companies are tying the 2 together i.e. if BNM goes ahead several insurance companies will drop traditional policies. Apparently the product become no more viable. But it is also likely that this is an arm twisting manoeuvre

IMHO, traditional products still can be viable if done according to BNM ideas, if the commissions for the first 3 years are reduced. (presently the first 3 years commssions easily exceed 60% of the annual premium).

But then, if the commissions are reduced, probably no agents will push this kind of products anymore, so most probably it will end up just like term life.

So, I agree and I guess very soon, investment linked policies will be the the only policies. But this will pose a problem for all insurance companies,... those agents without CEILI will not be able to sell investment linked products. I was told by one agent that the passing rate for CEILI is very low, even though in my opinion, the exams are in multiple choice and not difficult (I've seen the questions).

I guess we're diverting a bit from the original topic,...

keith
22-03-2005, 01:40 PM
it's not actually loading, but the pre-calculated premium for an age or age group.

You can easily find out how much premium you will need to pay from this year until the year the medical plan expires, e.g. from age 45 to age 70, and you can easily see how the medical premiums increase with age (which makes sense, right?), i.e. you know how much more premium you need to pay at age 65 even today.

Your life insurance agent must be refering to the ILP. The premium you pay is fixed, nonetheless the 'cost of insurance' deducted from your investment-linked policy will still increase every year according to your age.

As JG said, this increase in the 'cost of insurance' for your medical riders should be offset by your investment gains (if any), but there is always the possibility that your investment-linked funds did not gain enough to offset the increase in premiums, or worse yet, your investment-linked funds ended up losing money.

That is when you will get a nice letter from the insurance company advising you to top-up your investment-linked policy account, as your investment-linked fund has run out and there is no money left to pay off your 'cost of insurance'.

Always bear in mind that for ILP, the policyholders bear all the risk for their investments.

In general products medical plan, like Sihat Malaysia, not only the premium will increase based on age, the premium will also increase based on previous claims. So, for instance, one chap who used his Sihat Malaysia card this year for a huge sum medical fees will find next year his medical card either rejected or have higher loading premium, even after costing in his higher age.

I was told this is not applicable to medical cards from life companies because life products are not yearly renewable, but a medical rider within life plan, so there's no issue of loading, etc. ... but I'm not sure now.

totoro
22-03-2005, 01:47 PM
In general products medical plan, like Sihat Malaysia, not only the premium will increase based on age, the premium will also increase based on previous claims. So, for instance, one chap who used his Sihat Malaysia card this year for a huge sum medical fees will find next year his medical card either rejected or have higher loading premium, even after costing in his higher age.

I was told this is not applicable to medical cards from life companies,... but I'm not sure now.

That's why maybe it's not a good idea to buy from companies that are not able or willing to absorb fluctuations / risks. When medical costs went skyhigh a few years back, a lot of insurance companies revised their medical premiums upwards. The difference is that some increased it only in single-digit percentages, while others increased it more than 50%.

Stick to a well-established, trustworthy, stable and long-lasting insurer.

I guess guaranteed renewability means that once you have purchased the medical policy, you will not be penalized (with additional loading) when you renew next year, if ever a claim is made for any medical condition from the policy.

And yes, a lot of larger insurers do provide such clauses.

Joe Gomez
22-03-2005, 01:52 PM
I think you will agree that no matter how generous the payouts by insurance companies, as long as there are unscrupulous doctors around, ready to "skim the cream", so to say, the price of getting insurance for medical care will continue to head skywards ?

keith
22-03-2005, 01:53 PM
Stick to a well-established, trustworthy, stable and long-lasting insurer.


I read somewhere that Sihat Malaysia is dominated by one very large home grown Malaysia insurer. I believe they are in the top 5 life insurer in Malaysia. So, don't trust from only outlook or size,... still better do proper research and investigation... :)

Joe Gomez
22-03-2005, 01:59 PM
I read somewhere that Sihat Malaysia is dominated by one very large home grown Malaysia insurer. I believe they are in the top 5 life insurer in Malaysia. So, don't trust from only outlook or size,... still better do proper research and investigation... :)
Would you know whether Sihat Malaysia is still alive and well ?
I have been getting conflicting news about whther they are still operating.

keith
22-03-2005, 02:04 PM
Would you know whether Sihat Malaysia is still alive and well ?
I have been getting conflicting news about whther they are still operating.

IMHO, I guess Sihat Malaysia will eventually be phased out. This homegrown insurer that sell 60% of sihat malaysia has now their own medical plan, parked under their life division.

As I m not in this line, all i can guess is that they're reacting to market force, and follow what other life insurers have been offering in their medical plan - medical card plans.

orchipalar
22-03-2005, 02:04 PM
I think you will agree that no matter how generous the payouts by insurance companies, as long as there are unscrupulous doctors around, ready to "skim the cream", so to say, the price of getting insurance for medical care will continue to head skywards ?

Err...JG:)...though this is sadly true...the insurance companies should exercise due discretion in all fairness...with people whom had not been making claims as much... :o

JackRyan1975
22-03-2005, 02:06 PM
Would you know whether Sihat Malaysia is still alive and well ?
I have been getting conflicting news about whther they are still operating.

It's alive and kicking as far as I know. A relative of mine recently made a surgery and hospitalisation claim without any hassles. Low premium but they are good paymasters. :)

orchipalar
22-03-2005, 02:08 PM
Err...so now this is what Orchi wishes for...appreciates any good suggestions by PM only wor...:)

1. Husband 45yo(smoker)...absolutely no history of hospitalization whatsoever.
2. Wifey 37yo(asthmatic) no history of hospitalization otherthan when giving birth to...
3. Son 9yo...hospitalized once for high fever.
4. Son 6yo...hospitalised once for suspected food poisoning.

Orchi shall pay the best yearly premiums...for the best possible medical benefits worldwide from any reputable insurer...no future loadings...no BS!...guaranteed renewals for the same!

How much?...n where to sign up?

Err...could anyone be kind to offer Orchi...the contacts to Sihat Malaysia n AHA?...TQ:)

keith
22-03-2005, 02:12 PM
Err...could anyone be kind to offer Orchi...the contacts to Sihat Malaysia n AHA?...TQ:)

Sihat Malaysia is marketed by a few homegrown local insurance companies. Although the premium is much lower than other insurers, I have changed mine to a medical card that's tied to a life plan.

One thing I dont like abt Sihat Malaysia is that it's yearly renewable. A relative of mine had a major surgery on his first year Sihat Malaysia, and the following year, the premium increased by 50%.

Joe Gomez
22-03-2005, 02:24 PM
I think you will agree that no matter how generous the payouts by insurance companies, as long as there are unscrupulous doctors around, ready to "skim the cream", so to say, the price of getting insurance for medical care will continue to head skywards ?

Err...JG:)...though this is sadly true...the insurance companies should exercise due discretion in all fairness...with people whom had not been making claims as much... :o
If I get your question correct ......... I thought that is how it operates presently. Bukan macam itu ke, tai ko ? You are asking why insurers do not practice differential loading of premium only in those deserving cases and not across the board .... are you?
Crude though it might be, the insurers do load for those clients who have claimed in the past ......... However, after their illustrious employees, the actuaries, study recent trends in mortality stats, dietary stats ( yikes !!! ) and stats on obesity ( yukkss !! ), these highly paid individuals cld propose to the insurer to increase premiums acrosss the board. That is normal in the course of their business.

totoro
22-03-2005, 02:25 PM
Sihat Malaysia is marketed by a few homegrown local insurance companies. Although the premium is much lower than other insurers, I have changed mine to a medical card that's tied to a life plan.

One thing I dont like abt Sihat Malaysia is that it's yearly renewable. A relative of mine had a major surgery on his first year Sihat Malaysia, and the following year, the premium increased by 50%.

Insurance firms raise medical cover costs, set new conditions - The Star, December 10, 2002

KUALA LUMPUR: Insurers have started increasing health premiums by between 20% and 30% and are imposing new conditions on premiums to offset rising hospitalisation and surgical costs.

Many have cited a rise in claims made by private hospitals and abuse of the claims process as reasons. Among the measures already imposed or taking effect next year are:

* INCREASE in premiums by between 20% and 30%;
* SCRAPPING family packages and charging individual premiums;
* PAY first, claim later - under which those seeking treatment have to pay the medical fees first and claim the amount from the insurance company later; and
* COST-SHARING principle - 10% of the medical bills to be borne by policyholders. One insurance company, which used to charge a family of five RM600 in annual premium under Sihat Malaysia, has scrapped this facility and is now charging individual premiums, which could amount to RM 3,589. A company official said this was to offset the dramatic increase in claims made by private hospitals.

orchipalar
22-03-2005, 02:31 PM
If I get your question correct ......... I thought that is how it operates presently. Bukan macam itu ke, tai ko ? You are asking why insurers do not practice differential loading of premium only in those deserving cases and not across the board .... are you?
Crude though it might be, the insurers do load for those clients who have claimed in the past ......... However, after their illustrious employees, the actuaries, study recent trends in mortality stats, dietary stats ( yikes !!! ) and stats on obesity ( yukkss !! ), these highly paid individuals cld propose to the insurer to increase premiums acrosss the board. That is normal in the course of their business.

Err...JG:)...with the last insurer they kept on increasing the yearly premiums despite only having made 2 claims years back...

With the current ones...even without claims...they say in order to maintain the same coverage...err...the yearly premiums gotta go up still...? :confused:

totoro
22-03-2005, 02:35 PM
Err...JG:)...with the last insurer they kept on increasing the yearly premiums despite only having made 2 claims years back...

With the current ones...even without claims...they say in order to maintain the same coverage...err...the yearly premiums gotta go up still...? :confused:

I think there is some confusion on premiums and loading.

Let's say a company's standard premium rate table is as follows:

Age / Rate:
30 / RM100
40 / RM200
50 / RM300

But for a guy ORC, who has a previous medical history, he might be imposed a loading factor, thus for ORC, and ORC only, the rates are adjusted to become:

Age / Rate:
30 / RM150
40 / RM250
50 / RM400

Just as an example.

Joe Gomez
22-03-2005, 02:48 PM
orchi, is your hospitalisation plan a standalone one i.e. not attached to a life policy ?
And do you need to have it renewed annually ?
If YES to both, then totoro's illustration is spot on.
In which case, did your agent give you a brochure / illustration printed out to show what you can expect to pay over the years till 70 years of age ?
If he did then the progressive increases in premiums must stick to that premium rate tabulation. Only if there has been a claim, as in your situation, will the underwriters step in and re-assess the fresh risk involved and price the plan accordingly. When that latte happens there is no formula widely publicised and made known (cos they cant do that ) for computation of loading.

Joe Gomez
22-03-2005, 03:12 PM
Err...JG:)...with the last insurer they kept on increasing the yearly premiums despite only having made 2 claims years back...

With the current ones...even without claims...they say in order to maintain the same coverage...err...the yearly premiums gotta go up still...? :confused:
orchi, a claim made is an indication to the insuracne company of the presence of risk.
Similarly, even if claim was not made but the client had been hospitalised it still constitutes risk to the insurer.
For instance, my daughter was hospitalised with bronchitis. Doctors report said so. So I cld only get from my own company Great Eastern, a policy that specifically excludes any and all hospitalisation in connection with bronchial problems. An exclusion clause has been incorporated.
I thought it wise ( & was advised to do so by my upline ) to tell the insurer the truth and bite the bullet, so to say.
My general advise is not to succumb to the temptation of withhlding info from the next insurer, purly to get a better premium.
The law makes it incumbent on the proposer ( i.e. the person applying for the insurance cover ) to reveal to the insurer all such info which are considered "material". You must have heard of friends who talk about knowing some agent who "is not so fussy about such things". The friend talks in glowing terms about this agent he knows who will help you doctor the info in the proposal form to suit your specific needs. The Angelic Agent's only intetnion is to help. This Agent is a practising Christian OR Muslim OR Hindu OR Buddhist .... therefore,God fearing and all that ......... but he is prepared to flex his principles to help you big time.
This is major BULL****. He will probably be not around when a claim happens. If manipulation of info is suspected, no company can seem as "nasty" as an insurer, man. ( I mean the perception will be that the insurer is heartless and nasty ) They will go thru everything with a fine toothcomb. They are in the business of underwriting risks, tai ko .... so they have to do so if they suspect anything is amiss.

Having said that, IMHO, the higher premium is for the additional risk that the insurer sees in continuing coverage.

keith
22-03-2005, 03:31 PM
orchi, a claim made is an indication to the insuracne company of the presence of risk.
Similarly, even if claim was not made but the client had been hospitalised it still constitutes risk to the insurer.
For instance, my daughter was hospitalised with bronchitis. Doctors report said so. So I cld only get from my own company Great Eastern, a policy that specifically excludes any and all hospitalisation in connection with bronchial problems. An exclusion clause has been incorporated.
I thought it wise ( & was advised to do so by my upline ) to tell the insurer the truth and bite the bullet, so to say.
My general advise is not to succumb to the temptation of withhlding info from the next insurer, purly to get a better premium.
The law makes it incumbent on the proposer ( i.e. the person applying for the insurance cover ) to reveal to the insurer all such info which are considered "material". You must have heard of friends who talk about knowing some agent who "is not so fussy about such things". The friend talks in glowing terms about this agent he knows who will help you doctor the info in the proposal form to suit your specific needs. The Angelic Agent's only intetnion is to help. This Agent is a practising Christian OR Muslim OR Hindu OR Buddhist .... therefore,God fearing and all that ......... but he is prepared to flex his principles to help you big time.
This is major BULL****. He will probably be not around when a claim happens. If manipulation of info is suspected, no company can seem as "nasty" as an insurer, man. ( I mean the perception will be that the insurer is heartless and nasty ) They will go thru everything with a fine toothcomb. They are in the business of underwriting risks, tai ko .... so they have to do so if they suspect anything is amiss.

Having said that, IMHO, the higher premium is for the additional risk that the insurer sees in continuing coverage.

It's fresh to see honest insurance agents around... thanks to JG and Totoro.

Years back, I was approached by an agent of the giant international dutch insurance company; they were and still are very strong in medical plans, and guess what. This insurance agent told me "Don't worry Keith, I have doctor friend who can make sure that you will have a good night stay in the best suite in the hospital, take some vitamin C and other supplements, if you never make any claims that year to make sure that your money is fully utilised."

Did I sign for for the plan? You've guessed so,.... I never seen him ever after that. And most probably he's no longer in insurance line now...

Our insurance industry desperately need honest and knowledgable insurance agents, and the medical industry also need to be upfront honest.

Joe Gomez
22-03-2005, 04:03 PM
It's fresh to see honest insurance agents around... thanks to JG and Totoro. ...................
totoro is not an insurance guy ( he said so in another thread )..... but very knowledgeable we must admit.
Coming to think of it in yet another thread totoro said he gets a smaller bill at eateries when he goes dressed as a student ..... if u r a student man, totoro, I take my hat off lah.

totoro
22-03-2005, 04:11 PM
totoro is not an insurance guy ( he said so in another thread )..... but very knowledgeable we must admit.
Coming to think of it in yet another thread totoro said he gets a smaller bill at eateries when he goes dressed as a student ..... if u r a student man, totoro, I take my hat off lah.

why, tq JG *blush* :o

student? if u mean when i did my part-time mba, then maybe la, but... more like, baby-faced... lol... i was guessed at 21-yrs-old last weekend, but yestd at d pasar malam some middle-aged guys i bought food from called me uncle... :mad:

btw, just for d record, i -am- licenced to do insurance business. ;)

Joe Gomez
22-03-2005, 04:33 PM
Err...so now this is what Orchi wishes for...appreciates any good suggestions by PM only wor...:)

1. Husband 45yo(smoker)...absolutely no history of hospitalization whatsoever.
2. Wifey 37yo(asthmatic) no history of hospitalization otherthan when giving birth to...
3. Son 9yo...hospitalized once for high fever.
4. Son 6yo...hospitalised once for suspected food poisoning.

Orchi shall pay the best yearly premiums...for the best possible medical benefits worldwide from any reputable insurer...no future loadings...no BS!...guaranteed renewals for the same!

How much?...n where to sign up?
Tai ko, susah nah menyempurnakan permintaan ini lah.
Especially because of the highly charged word "BS" ( I dont think you mean "ButterScotch" )
Tell me which Direct Selling gig has not been levelled with that accusation todate ?
Everything depends on the bugger pushing the product lah. And if I may add, also upon the manner in which the client understands or chooses to understand the merits or demrits of the products or services.
Having said that, it is true that the image of Direct Selling stinks mainly because the attitudes and commitments of the buggers pushing the products or services stink.

orchipalar
22-03-2005, 04:42 PM
Orchi shall pay the best yearly premiums...for the best possible medical benefits worldwide from any reputable insurer...no future loadings...no BS!...guaranteed renewals for the same!

How much?...n where to sign up?

Err...sorry Ah Neh:)...typo error lar...hehe...all things said...no future unfair loadings...ok oh? :)

orchipalar
22-03-2005, 04:48 PM
Having said that, IMHO, the higher premium is for the additional risk that the insurer sees in continuing coverage.

Err...JG:)...so all this while Orchi been fed with incomplete infos from an agent friend of 20 years! :o

N...since Orchi never checked with another source....got nobody else to blame except Orchi ownself! :o

totoro
22-03-2005, 04:52 PM
Having said that, IMHO, the higher premium is for the additional risk that the insurer sees in continuing coverage.

Err...JG:)...so all this while Orchi been fed with incomplete infos from an agent friend of 20 years! :o

N...since Orchi never checked with another source....got nobody else to blame except Orchi ownself! :o

if u find a guaranteed renewability clause without extra loading, then by all means, go for it. :D

orchipalar
22-03-2005, 05:06 PM
if u find a guaranteed renewability clause without extra loading, then by all means, go for it.

Err...aiyoo!...Orchi just took a fall...n still gotto be subjected to you tendang Orchi's punya butt...aiyoo!...lagi sakit liao... :D

Joe Gomez
22-03-2005, 05:34 PM
Having said that, IMHO, the higher premium is for the additional risk that the insurer sees in continuing coverage.

Err...JG:)...so all this while Orchi been fed with incomplete infos from an agent friend of 20 years! :o

N...since Orchi never checked with another source....got nobody else to blame except Orchi ownself! :o
Sorry, orchi, let me say what is not a very nice thing to say lah.
Yes got nobody else to blame except Orchi ownself! ;) ;) cos the communication of info is a 2-way thingey. It takes a sender and a receiver. In this case, the sender loses nothing if the receiver does not understand what he is getting himself into. The receiver has everything to lose. So it is incumbent upon the receiver to receive loud and clear and kick the sender's butt if he does not divulge info.
Reality check ..... an insurance contract ( as far as contracts go ) is no different from any other contract. The only difference is that there is a very highly emotion charged situation surrounding the delivering of the promise offered by an insurance contract. Typically death, ill health, diability etc. Hence emotions & expectations run high. Shouldnt therefore extreme care be exercised at the point of one getting into such a contract. Shouldnt one know that one is the other signatory to the contract, for God's sake. The bu**er ( have no ambition to become "bananas". Thanks for alert, chang ) I bought from is a friend and all the more I shd have asked the bloke every material thing there is to know about this contract.

Cheers tai ko.